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Avelumab + utomilumab + rituximab is an investigational combination therapy consisting of three monoclonal antibodies: - **Avelumab**: An anti-PD-L1 monoclonal antibody that blocks the programmed death-ligand 1 (PD-L1) on tumor cells, enhancing T-cell mediated antitumor responses. - **Utomilumab**: An agonist monoclonal antibody targeting 4-1BB (CD137), a co-stimulatory receptor on T cells, leading to increased immune cell activation and antibody-dependent cellular cytotoxicity. - **Rituximab**: An anti-CD20 monoclonal antibody that targets CD20-positive B cells for antibody-dependent cell-mediated killing. This combination is designed to synergize through checkpoint inhibition, immune co-stimulation, and direct B-cell depletion, and has been investigated for the treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL)[1][4]. The therapy was evaluated in phase Ib clinical trials, but limited efficacy was observed with only one partial response and overall response rate of 11.1% in the studied arm (DLBCL)[1]. The companies involved in the development and trialing of these agents are Pfizer (avelumab, utomilumab) and Merck (avelumab), and rituximab is developed by Genentech/Roche and Biogen.
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